Kuala Lumpur: Malaysia remains in deep denial about its growing epidemic in gay men and transgender communities even though the number of HIV cases is moving from injecting drug users to more new infections from sexual transmission, says the Muslim country’s leading academic on HIV/AIDS.
“The real problems are now with prevention for MSM [men who have sex with men], transgenders, and sex workers. There’s almost no kind of nationwide program to make any dent in the epidemic among these populations,” Adeeba Kamarulzaman told sciencemag.org.
Kamarulzaman who has a medical degree from Australia and a specialty in infectious diseases is dean of the faculty of medicine at the University of Malaya. She was instrumental in curbing the epidemic in people who inject drugs by advocating harm reduction policies.
She has published more than 100 studies of HIV/AIDS in Malaysia ranging from harm reduction policies to the molecular epidemiology and the efficacy of new treatments.
Stopping the spread of HIV among injecting drug users was Kamarulzaman’s first campaign in 2003 where she set out to influence drug policy that was heavily focused on punishment by gathering comprehensive data about HIV and users who injected which accounted for 76 percent of the infections.
It did little to sway the National Anti-Drugs Agency and the police till she used her connections related to Malaysian royalty to set up a meeting with the Cabinet Committee on Drugs, which later approved a pilot project to convert injecting drug users to methadone.
Many have noted how the government then moved away from a strictly punitive attitude toward drug users to a more compassionate view pertaining to a health problem when in 2010 voluntary “cure and care” centers began to replace compulsory drug rehabilitation centers.
Kamarulzaman maintains that harm reduction advocacy has helped in fighting the HIV epidemic in Malaysia because it has emphasized “Islamic values about the preservation of life.”
However, the same argument is not applicable to infections from sexual transmission. “It’s a little bit more difficult to argue for sex work and MSM along those veins,” she says. Shariah law in some states can imprison Malay Muslims for simply cross-dressing, she pointed out.
Ministry of Health data shows that in small surveys of MSM, HIV prevalence had a increase from 3.9% to 12.6%” between 2009 and 2012.
“New HIV infections via sexual transmission have outnumbered drug injection for the past 3 years,” says an official from the Malaysian AIDS Council. “And until today, the government has not done anything new, and they are fully aware of what is happening.”
Kamarulzaman says the government “urgently” needs to address its shortcomings.
The government’s attitude towards the LGBT community is shaped by Islam, the official religion in Malaysia and where same-sex relations is a crime and punishable by up to 20 years in jail.